Physician Compare National (NPI:1467611566)

HEALTHCARE PROVIDER: ANDRE YUAN LEVESQUE M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1467611566
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335389204
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160822001760
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LEVESQUE
	Individual professional last name
Provider First Name	ANDRE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	3737 EXECUTIVE CTR DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 105
	Group Practice or individual's line 2 address
City	AUSTIN
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	787311632
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450713
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST DAVID'S SOUTH AUSTIN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y